Chakrabortty S, Oi S, Yamaguchi M, Tamaki N, Matsumoto S
Department of Neurosurgery, Kobe University School of Medicine.
Neurol Med Chir (Tokyo). 1993 Feb;33(2):81-5. doi: 10.2176/nmc.33.81.
Twelve patients with growth hormone-producing pituitary adenomas were investigated to evaluate correlations between magnetic resonance (MR) appearance and tissue characteristics, sellar expansion, suprasellar tumor extension, and tumor consistency. MR imaging could detect microadenomas with a characteristic enhancement delay of gadolinium-diethylenetriaminepenta-acetic acid in the surrounding normal pituitary gland. Macroadenomas and giant tumors appeared on T2-weighted images as mostly high intensity, while varied greatly on T1-weighted images. The signal intensities of growth hormone-producing adenomas were more homogeneous (80%) than those of other functioning and non-functioning adenomas on T1-weighted images. However, there was no typical MR imaging for the tissue characteristics of the growth hormone-producing adenomas, and no particular correlation with suprasellar extension or consistency. Postoperative MR findings showed that the transcranial approach was superior for total or subtotal removal of large tumors, especially with suprasellar extension up to the upper third ventricle. The transsphenoidal approach can achieve a satisfactory decompressive effect on the optic chiasm, but more radical removal is required to achieve a normal hormone level.
对12例生长激素分泌型垂体腺瘤患者进行研究，以评估磁共振（MR）表现与组织特征、蝶鞍扩大、鞍上肿瘤延伸及肿瘤质地之间的相关性。MR成像能够检测出微腺瘤，其在周围正常垂体腺内钆-二乙三胺五乙酸有特征性增强延迟。大腺瘤和巨大肿瘤在T2加权像上大多表现为高信号，而在T1加权像上差异很大。在T1加权像上，生长激素分泌型腺瘤的信号强度比其他功能性和无功能性腺瘤更均匀（80%）。然而，对于生长激素分泌型腺瘤的组织特征，没有典型的MR成像表现，且与鞍上延伸或质地无特定相关性。术后MR表现显示，经颅入路对于大型肿瘤的全切或次全切更具优势，尤其是鞍上延伸至第三脑室上部的肿瘤。经蝶窦入路对视交叉可实现满意的减压效果，但要使激素水平恢复正常则需要更彻底的切除。
